It is imperative to have a proper transition of care from Acute care admission from a hospital, a nursing home, or an emergency room to home. We have a fragmented healthcare delivery system. Our healthcare is built on providing more and more service. There is practically no effective communication between acute care facilities and medical offices. Recently, a lot of regulation are put in place to allow the flow of information from hospital, nursing homes and Emergency rooms to doctor offices. Primary care practices must be innovative and persistent to get complete information.. The intention of TRC program is to have a correct and proper transition of care to prevent complications and readmissions to hospitals. According to NCQA, currently Medicare beneficiaries are not getting adequate support during this process leading to about $377.5 billions per year in Hospital cost.
Our health coaches will follow and work with you while you are in the hospital and on discharge. We will get your discharge medication lists and providers will ensure that you are getting proper medications. Medication errors are most common in the transition period leading to complications.